Emergency Care Waiting Time Statistics (January – March 2018)

Date published: 26 April 2018

The Department of Health (DoH) today published statistics on the time spent in emergency care departments (ED) throughout Northern Ireland during the months of January, February and March 2018.

Emergency Care Waiting Times

The statistical bulletin presents information on all new and unplanned review attendances during January, February and March 2018. It details information on the time spent in EDs during each of these months including; the monthly performance against the DoH emergency care waiting times target for EDs and the time waited for key milestones during a patient’s journey through ED, whilst they are being cared for in an ED, including the time to triage and time to start of treatment.

This information release is published on the Departmental website here.

Key Points

Attendances at Emergency Care Departments:

Attendances:

  • During March 2018, there were 68,846 attendances at EDs in Northern Ireland, 430 (0.6%) more than in March 2017 (68,416).
  • Of the 68,846 ED attendances during March 2018, 56,428 (82.0%) had attended a Type 1 ED, 5,675 (8.2%) attended a Type 2 ED and 6,743 (9.8%) attended a Type 3 ED.
  • Between March 2017 and March 2018, attendances increased at Type 1 EDs (906, 1.6%), stayed the same at Type 2 EDs, but decreased at Type 3 EDs (489, 6.8%).
  • During the quarter ending 31 March 2018, there were 188,081 attendances at EDs in Northern Ireland, 2.9% (5,316) more than the same quarter in 2017.

Left before Treatment Complete:

  • During March 2018, 4.8% of the 68,846 ED attendances left before their treatment had been completed.

Unplanned Re-Attendances within 7 Days:

  • During March 2018, 3.7% of the 68,846 ED attendances were unplanned review attendances who had returned to the same ED within 7 days of their original attendance for the same condition.

Referrals by GP:

  • Almost a fifth (18.2%) of attendances at EDs in March 2018 had been referred by a GP, 1.0 percentage point higher than March 2017 (17.2%).

Time Spent in Emergency Care Departments:

Performance against Targets

  • Almost three fifths (59.3%) of patients attending a Type 1 ED in March 2018 were treated and discharged, or admitted within 4 hours of their arrival, 10.9 percentage points lower than March 2017 (70.2%).
  • Over eight in ten (82.2%) patients attending a Type 2 ED in March 2018 were treated and discharged, or admitted within 4 hours of their arrival, 5.7 percentage points less than March 2017 (87.9%).
  • Almost all (99.5%) patients attending a Type 3 ED were treated and discharged, or admitted within 4 hours of their arrival.
  • Between March 2017 and March 2018, the number of attendances waiting longer than 12 hours increased from 585 to 3,169, accounting for 4.6% of all attendances in March 2018.
  • Almost three quarters (74.7%) of patients attending EDs commenced their treatment within 2 hours of being triaged in March 2018, lower than March 2017 (82.3%).
  • During the quarter ending 31 March 2018, almost two thirds (65.5%) of patients were treated and discharged or admitted within 4 hours, 8.1 percentage points less than the same quarter in 2017. The number of attendances waiting longer than 12 hours in this period increased from 3,115 to 9,567, a three-fold increase.

Time to Triage:

  • The median waiting time from arrival at an ED to triage (initial assessment) by a medical professional was 10 minutes during March 2018, with 95 percent of patients having their care needs assessed for the first time by a medical professional within 43 minutes of arrival.

Time to Start of Treatment:

  • During March 2018, the median waiting time from triage to the start of treatment by a medical professional was 52 minutes, with 95 percent of patients receiving treatment within 4 hours 35 minutes of being triaged.

Total Time in Emergency Care Department:

  • The median time spent in a Type 1 ED by patients who were discharged home (not admitted) was 2 hours 53 minutes in March 2018, 26 minutes longer than the same month last year (2 hours 27 minutes).
  • The median time spent in a Type 1 ED for patients admitted to hospital was 7 hours 16 minutes in March 2018, 1 hour 55 minutes longer than the same month last year (5 hours 21 minutes).
  • During March 2018, the Ulster and Royal Victoria reported the longest median waiting times (8 hours 21 minutes and 8 Hours 20 minutes respectively) from arrival to admission to hospital, whilst the RBHSC reported the shortest median time of 4 hours 18 minutes.

Notes to editors: 

  1. This statistical bulletin reports the total time spent in an ED from arrival until admission, transfer or discharge for all new and unplanned review attendances at emergency care departments across NI. The figures do not include planned review attendances.
     
  2. Time is measured from when a patient arrives at the ED (time of arrival is recorded at registration or triage whichever is earlier (clock starts)) until the patient departs the ED (time of departure is defined as when the patient's clinical care episode is completed within the ED (clock stops)).
     
  3. The current Ministerial targets for emergency care waiting times in 2017/18 state that:  

    ‘From April 2017, 95% of patients attending any Type 1, 2 or 3 Emergency Care Department are either treated and discharged home, or admitted, within four hours of their arrival in the department; and no patient attending any Emergency Care Department should wait longer than 12 hours.’

    ‘By March 2018, at least 80% of patients to have commenced treatment, following triage, within 2 hours.’
     
  4. Information which presents a summary of the emergency care clinical quality indicators for Northern Ireland has also been included in this release. This information is not National Statistics but has been included to provide a more comprehensive and balanced view of the care delivered by EDs and reflects the experience of patients and the timeliness of the care they receive.
     
  5. Readers are advised to be cautious when making direct comparisons between Northern Ireland and other UK Jurisdictions as waiting times may not be measured in a comparable manner.  It should also be noted that the way in which emergency care services are delivered differs between UK jurisdictions. This means that the number and types of patients included in the figures may differ between countries. In particular, the 12-hour waiting time information published by England and Northern Ireland is not equivalent and should not be compared. Further information on comparability between Northern Ireland and other UK Jurisdictions are included in the ‘Emergency Care Waiting Time Statistics – Additional Guidance’ booklet
     
  6. The DoH have liaised with colleagues in England, Scotland and Wales to clarify differences between the emergency care waiting times reported for each administration and have produced a guidance document to provide readers with a clear understanding of these differences .
     
  7. There are three separate categories of emergency care facility included in this publication:

    Type 1 Department
    A consultant-led service with designated accommodation for the reception of emergency care patients, providing both emergency medicine and emergency surgical services 24 hours a day.

    Type 2 Department
    A consultant-led service with designated accommodation for the reception of emergency care patients, but which does not provide both emergency medicine and emergency surgical services and/or has time-limited opening hours.

    Type 3 Department
    A minor injury unit with designated accommodation for the reception of patients with a minor injury and/or illness. It may be a doctor or nurse-led. A defining characteristic of this service is that it treats at least minor injuries and/or illnesses and can be routinely accessed without an appointment.
     
  8. Figures incorporate all returns and amendments received from HSC Trusts up to 23rd April 2018.

Further information on Emergency Care Statistics is available from:

Hospital Information Branch
Department of Health
Annexe 2, Castle Buildings
Stormont,
BT4 3SQ
Email: statistics@health-ni.gov.uk
Internet

9.  Media queries to DoH Information Office on 028 90 520579, or out of hours contact the Duty Press Officer via pager number 07699 715440 and your call will be immediately returned.

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